scholarly journals Trichotillomania and Dermatitis Artefacta: A Rare Coexistence

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Neeraj Varyani ◽  
Sunny Garg ◽  
Garima Gupta ◽  
Shivendra Singh ◽  
Kamlakar Tripathi
Keyword(s):  
Blood Pressure ◽  
Conservative Management ◽  
Lower Limb ◽  
Skin Lesions ◽  
The Body ◽  
Lower Limbs ◽  
Dermatitis Artefacta ◽  
Bilateral Lower Limb ◽  
Pedal Edema

A 24-year-old pregnant female patient presented with complains of bilateral lower limb swelling and fever for 1 month. On examination, blood pressure was 144/94 mmHg along with pitting pedal edema. She had bizarre skin lesions, aligned longitudinally and distributed over the approachable site of the body with tapering ends and in various stages of healing. Lower limbs examination also revealed similar lesions with signs of cellulitis. Her scalp had short and distorted hair suggesting pulling and plucking. These skin lesions and the denial of self-infliction by the patient made us reach the diagnosis of dermatitis artefacta with trichotillomania. Psychotherapy was advocated along with conservative management of skin lesions. The patient improved and is under our follow up.

scholarly journals Elephantiasis and Directed Occupational Rehabilitation

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Jose Maria Pereira de Godoy ◽  
Henrique Jose Pereira de Godoy ◽  
Ana Carolina Pereira de Godoy ◽  
Maria de Fátima Guerreiro Godoy
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Lower Limb ◽  
Occupational Rehabilitation ◽  
The Body ◽  
Compression Stockings ◽  
Left Lower Limb ◽  
History Of ◽  
Bilateral Lower Limb

The aim of the present study was to demonstrate the cure of elephantiasis over a ten-year follow-up period and novel discoveries with directed occupational rehabilitation. A 66-year-old female patient with a history of bilateral lower limb lymphedema reported the aggravation of the condition over the years, reaching stage III (elephantiasis). The physical examination confirmed elephantiasis. The circumference of the left lower limb was 106 cm. Her body weight was 106 kilograms, height was 160 cm, and the body mass index (BMI) was 41.6 kg/m2. The patient was submitted to intensive treatment for three weeks, which led to a 21-kg reduction in weight and 66 cm reduction in leg circumference. Ten years after treatment, the patient has maintained the results with the compression stockings. Elephantiasis can be cured, although lymphedema cannot. The cure of elephantiasis depends on maintaining the treatment of lymphedema after normalization or near normalization. Directed occupational therapy stimulates the search for new activities and a life closer to normality.

scholarly journals A rare extensive clinical presentation of calciphylaxis due to primary hyperparathyroidism

2020 ◽  
Vol 7 (11) ◽  
pp. 3827
Author(s):  
Mohamad Safwan A. ◽  
K. N. Vijayan ◽  
Akash S. ◽  
Ashwini T. ◽  
Muhammed Irfan K. P. C.
Keyword(s):  
Parathyroid Adenoma ◽  
Lower Limb ◽  
Multiorgan Failure ◽  
Skin Lesions ◽  
High Serum ◽  
Lower Limbs ◽  
Elevated Alkaline Phosphatase ◽  
Sestamibi Scan ◽  
Bilateral Lower Limb ◽  
Proximal Myopathy

Calciphylaxis is a dreadful condition predominantly seen in chronic kidney disease patients on haemodialysis or following renal transplant. Calciphylaxis occurring in patients with normal kidney function is extremely rare. Here we present 53-year-old women presented with painful, extensive eschar-like skin lesions involving bilateral lower limb of 3 months of duration. She had hypercalcemia, high serum parathyroid hormone (PTH) levels and elevated alkaline phosphatase. Ultrasound neck and sestamibi scan demonstrated left inferior parathyroid adenoma. Lower limb radiographic studies showed subcutaneous calcification. Cutaneous biopsy confirmed calciphylaxis. Cinacalcet to control hypercalcemia, antibiotics and pain control medications were started. Left inferior parathyroidectomy and debridement of gangrenous lesions of lower limbs were performed. Histopathology was consistent with parathyroid adenoma. Lower limb wound started granulating with Vacuum-assisted closure (VAC) dressing and skin graft was planned. Unfortunately, she succumbed 11 weeks from surgery due to proximal myopathy, aspiration pneumonitis, sepsis and multiorgan failure.

scholarly journals AN AYURVEDIC MANAGEMENT OF ALCOHOLIC LIVER DISEASE W.S.R TO SHAKHASHRITA KAMALA - A CASE STUDY

2021 ◽  
Vol 9 (11) ◽  
pp. 2870-2876
Author(s):  
Samata Samata ◽  
Shaila Borannavar ◽  
Ananta S Desai
Keyword(s):  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Pathological Condition ◽  
The Body ◽  
Lower Limbs ◽  
Medical College ◽  
Chief Complaints ◽  
Excessive Consumption ◽  
Bilateral Lower Limb ◽  
Deep Yellow

Alcoholic liver disease is a pathological condition of the liver parenchymal tissue due to excessive consumption of alcohol over a long period of 6-10 years or even earlier. Here in we present a case of a married male of 35 yr. old reported in the Panchakarma OPD of SJIIM Government Ayurveda Medical College Bengaluru on 30th -Jan- 2021, with chief complaints of swelling in the bilateral lower limbs, deep yellowish and burning micturition, yel- lowish discoloration of sclera, reduced appetite, nausea and generalized weakness in the body since 3 months, with the increased level of LFT and USG-abdomen report suggesting hepatomegaly with fatty changes, was ex- amined and diagnosed as alcoholic liver disease and treated with Amapachana with Trikatu Churna, Nitya Virechana with Chitraka Haritaki Leha fallowed by Mustadi Yapana Basti had shown a very good improvement in normalizing appetite, bilateral lower limb swelling and deep yellow micturition. Total bilirubin, SGOT and ALP values were reduced. Keywords: Alcoholic Liver disease, Shakhashrita Kamala, Nitya Virechana

Iliac Venous Obstruction: Surgical Reconstruction

2000 ◽  
Vol 15 (3-4) ◽  
pp. 144-148
Author(s):  
F. Mercier ◽  
F. Cormier ◽  
J. M. Fichelle ◽  
F. Duarte ◽  
J. M. Cormier
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Surgical Reconstruction ◽  
Invasive Technique ◽  
Venous Obstruction ◽  
Long Term Outcome ◽  
First Choice

Aim: To review the investigation and treatment of iliac vein obstruction. Method: A review of current literature in the field of management of iliac venous obstruction has been conducted. Synthesis: Iliac venous obstruction results in chronic or acute symptoms in the lower limb presenting as pain, swelling, oedema and discomfort of the lower limb. Intrinsic or extrinsic obstruction of the iliac veins may be the cause. Cockett syndrome is the classic aetiology for chronic intermittent or fixed left inferior limb venous obstruction. Other causes include tumours, vascular grafts or lymph node compression and retroperitoneal fibrosis. Duplex ultrasound imaging is now the first-choice investigation. CT scanning is useful where external vein compression is suspected. Phlebography is used when an endovascular procedure is to be done. The surgical treatment of Cockett syndrome described by Cormier is transposition of the common right iliac artery in the left internal iliac artery. This is being replaced by endovascular balloon venoplasty completed by stenting of the left iliac vein. We reviewed the experience of surgical correction of Cockett syndrome with Cormier's technique in 70 patients operated on between 1976 and 1990; 55 patients had a follow-up of 12-177 months. Anatomical and functional results were perfect for all patients except when endoluminal synechiae or iliac venous thrombosis were associated with postural compression. In this case a 50% success rate was achieved. The endovascular revolution offers a less invasive technique for treatment of chronic iliac venous obstruction. Follow-up is short at present in the few publications found in the literature. Conclusions: Iliac vein obstruction results in symptoms of swelling in the lower limbs. These may be managed conservatively. Where there is an indication for venous reconstruction, investigation by duplex ultrasonography is the first step. Endovascular procedures including stenting offer significant benefit. The long-term outcome of these interventions has yet to be established.

Percutaneous Endoscopic Interlaminar Unilateral Ventral Dural Approach for Symptomatic Bilateral L5–S1 Herniated Nucleus Pulposus: Technical Note

2018 ◽  
Vol 79 (06) ◽  
pp. 518-523 ◽  
Author(s):  
Sung Choi ◽  
Nitin Adsul ◽  
Ki Kim ◽  
Jeong Kim ◽  
Sung Chung ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Lower Limb ◽  
Leg Pain ◽  
Limb Pain ◽  
Lumbar Disk Herniation ◽  
Interlaminar Approach ◽  
Lower Limb Pain ◽  
Bilateral Lower Limb ◽  
Herniated Nucleus Pulposus

Background Percutaneous endoscopic lumbar diskectomy is a good treatment modality for lumbar disk herniation. However, when a patient complains of bilateral lower limb radicular pain with severe disk protrusion at the L5–S1 level, the transforaminal approach is often unable to resolve both lesions owing to anatomical limitations. It is also very difficult to resolve both lesions in an ipsilateral direction using the percutaneous interlaminar approach. We report our surgical technique and clinical results using a ventral dural approach of percutaneous endoscopic interlaminar lumbar diskectomy for L5–S1 herniated nucleus pulposus (HNP) in patients with bilateral radiculopathy due to a severe disk protrusion. Methods Twenty-seven patients with severe L5–S1 HNP complaining of back pain and bilateral lower limb pain were included in the study. The unilateral ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy technique was used. The visual analog scale (VAS) and Macnab criteria were used for clinical evaluation. All assessments were completed 1 day before surgery, 1 week after surgery, 6 months after surgery, and at final follow-up after surgery. Results The mean preoperative back and leg pain VAS scores decreased from 5.67 ± 0.78 and 7.81 ± 0.83 to 2.44 ± 0.58 and 2.26 ± 0.53 at 1 week, 1.78 ± 0.51 and 1.52 ± 0.58 at 6 months, and 1.56 ± 0.70 and 1.67 ± 0.96, respectively, at the final follow-up after surgery. With respect to the Macnab criteria, 51.85% of the results were excellent, 44.44% were good, and 3.70% were fair. Four cases recurred: three patients underwent conservative treatment and one patient operated with percutaneous endoscopic interlaminar lumbar diskectomy. Conclusion According to the results of this study, the ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy in patients with L5–S1 HNP associated with bilateral lower limb pain due to a severely protruded HNP is a good option for a minimally invasive surgical approach.

scholarly journals Theoretical and practical considerations regarding the study of cranial circulation by measuring blood pressure at the two ends of the carotid artery

2020 ◽  
Vol VI (2) ◽  
pp. 95-119
Author(s):  
F. N. Telyatnik
Keyword(s):  
Blood Pressure ◽  
Carotid Artery ◽  
Peripheral Nerve ◽  
Lower Limb ◽  
Blood Circulation ◽  
The State ◽  
The Body ◽  
The Other ◽  
Small Arteries ◽  
The One

Of all the methods of studying cranial blood circulation, which I will not list here, the best is the one in which the state of cranial blood circulation is judged by the blood pressure in the two ends of the carotid artery. Hrthle was the first to observe this method, and therefore the method itself is often called the Hrthle method. However, as Hrthle himself says, the idea of ​​a method existed before. So, A. Dastre and J. Morat, for the purpose of proving the existence of vasomotor fibers for the lower limb in n. ischiadicus, determined the blood pressure in the central end of one a. cruralis and in the peripheral end the other; on the side last n. ischiadicus overcame. With irritation of a peripheral nerve cut, the pressure increased in the peripheral end of the а. cruralis, remaining unchanged in the central cut. This increase in pressure in the operated limb, which coincides with the unchanged pressure in the rest of the body, proves that (with the indicated irritation) there is a reduction in small arteries.

scholarly journals Therapy of obesity by sibutramin: polymorphisms of TPH2 and GNB3 genes and decrease of body weight

2018 ◽  
Vol 15 (2) ◽  
pp. 40-45
Author(s):  
Marina O. Galieva ◽  
Ekaterina A. Troshina ◽  
Nataliya V. Mazurina ◽  
Anna P. Volynkina ◽  
Andrey V. Artiushin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Weight Loss ◽  
Body Weight ◽  
Genetic Factors ◽  
Research Study ◽  
Body Weight Loss ◽  
The Body ◽  
Tph2 Gene

Aims. To study of the polymorphisms of the TPN2 and GNB3 genes in obese patients and their effect on weight loss in patients on sibutramine therapy. Materials and methods. The research study included 118 patients with exogenous-constitutional obesity who received Reduxin (sibutramine + CMC) at the dose of 10 mg. Term follow-up was 3 months. A genetic study was performed to assess ТРН2 and GNB3 gene polymorphisms. The response to the therapy was evaluated after 3 months by the dynamics of body weight. Results. In the study the G703T polymorphism of the GNB3 gene showed that during 3 months of observation, carriers of the TT genotype had a greater decrease in body weight in comparison with carriers of the allele C -8 kg (-12; -5) vs. -5 kg (-8; -3), p = 0.018. In carriers of different variants of the genotype of the TPH2 gene (polymorphism C825T), there was no difference in body weight dynamics with sibutramine therapy. There was no correlation between the foresaid polymorphisms of the TPH2 and GNB3 genes with the indices of blood pressure and heart rate. Conclusions. 1. The result of sibutramin therapy may depend on genetic factors: in carriers of the TT-genotype C825T of the GNB3 gene the body weight loss was higher than among the carriers of the C allele. 2. Changes in blood pressure and heart rate did not show any statistically significant relationship with polymorphisms of the TPH2 and GNB3 genes.

scholarly journals Design and Analysis of a Lower Limb Rehabilitation Training Component for Bedridden Stroke Patients

Machines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 224
Author(s):  
Xusheng Wang ◽  
Yongfei Feng ◽  
Jiazhong Zhang ◽  
Yungui Li ◽  
Jianye Niu ◽  
...  
Keyword(s):  
Lower Limb ◽  
Interventional Therapy ◽  
The Body ◽  
Lower Limbs ◽  
Linkage Mechanism ◽  
Training Module ◽  
Stroke Patients ◽  
Rehabilitation Training ◽  
Limb Rehabilitation ◽  
Lower Limb Rehabilitation

Carrying out the immediate rehabilitation interventional therapy will better improve the curative effect of rehabilitation therapy, after the condition of bedridden stroke patients becomes stable. A new lower limb rehabilitation training module, as a component of a synchronous rehabilitation robot for bedridden stroke patients’ upper and lower limbs, is proposed. It can electrically adjust the body shape of patients with a different weight and height. Firstly, the innovative mechanism design of the lower limb rehabilitation training module is studied. Then, the mechanism of the lower limb rehabilitation module is simplified and the geometric relationship of the human–machine linkage mechanism is deduced. Next, the trajectory planning and dynamic modeling of the human–machine linkage mechanism are carried out. Based on the analysis of the static moment safety protection of the human–machine linkage model, the motor driving force required in the rehabilitation process is calculated to achieve the purpose of rationalizing the rehabilitation movement of the patient’s lower limb. To reconstruct the patient’s motor functions, an active training control strategy based on the sandy soil model is proposed. Finally, the experimental platform of the proposed robot is constructed, and the preliminary physical experiment proves the feasibility of the lower limb rehabilitation component.

Sensitivity of the Toe Height to Multijoint Angular Changes in the Lower Limbs During Unobstructed and Obstructed Gait

2020 ◽  
pp. 1-9
Author(s):  
Chuyi Cui ◽  
Brittney Muir ◽  
Shirley Rietdyk ◽  
Jeffrey Haddad ◽  
Richard van Emmerik ◽  
...  
Keyword(s):  
Young Adults ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Singular Value ◽  
Lower Limbs ◽  
Joint Angles ◽  
Adult Lifespan ◽  
Main Contributor ◽  
Bilateral Lower Limb

Tripping while walking is a main contributor to falls across the adult lifespan. Trip risk is proportional to variability in toe clearance. To determine the sources of this variability, the authors computed for 10 young adults the sensitivity of toe clearance to 10 bilateral lower limb joint angles during unobstructed and obstructed walking when the lead and the trail limb crossed the obstacle. The authors computed a novel measure—singular value of the appropriate Jacobian—as the combined toe clearance sensitivity to 4 groups of angles: all sagittal and all frontal plane angles and all swing and all stance limb angles. Toe clearance was most sensitive to the stance hip ab/adduction for unobstructed gait. For obstructed gait, sensitivity to other joints increased and matched the sensitivity to stance hip ab/adduction. Combined sensitivities revealed critical information that was not evident in the sensitivities to individual angles. The combined sensitivity to stance limb angles was 84% higher than swing limb angles. The combined sensitivity to the sagittal plane angles was lower than the sensitivity to the frontal plane angles during unobstructed gait, and this relation was reversed during obstacle crossing. The results highlight the importance of the stance limb joints and indicate that frontal plane angles should not be ignored.

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